Just a flare---the Pandora's box approach.

Systemic lupus erythematosus is a chronic inflammatory autoimmune disease characterized by autoantibodies specific for highly conserved nuclear antigens, such as double-stranded DNA, histones and ribonuclear proteins. The course of the disease is unpredictable and nine times more common in females. Among the neurological manifestations of collagen vascular diseases is the most commonly recognized and better studied disease. Central nervous system lupus is a serious and potentially treatable illness presenting as difficult diagnostic challenge. This is a case report of a patient that suffered central nervous system manifestations of severe active lupus. Early recognition of this entity is essential to expedite appropriate to treatment and avoid future complications.

An unusual presentation of herpes simplex in an immunocompromised patient.

Herpes simplex virus (HSV) is a host-adapted human pathogen. HSV-I usually infects non-genital sites at a variety of locations. HSV-2 primarily involves genitalia. Both types can cause genital and orofacial infections, which are clinically indistinguishable. Initial HSV infection is usually asymptomatic or mild and self-limited, but instead of disappearing from the body during convalescence, the virus establishes a latent infection that persists for life. Rarely, there is severe visceral dissemination. This is a case report of an unusual presentation of herpes simplex in an immunocompromised adult patient with generalized skin lesions on the entire body. To our knowledge, this is the first case reported in the literature of a disseminated herpes simplex in a patient with history of non-Hodgkin Lymphoma. Generalized HSV infection in immunodeficient adult patients could be fatal in spite of antiviral therapy. Early recognition of this entity is essential to expedite appropriate treatment and avoid future complications.

Mycotic aneurysm: a rare complication of vertebral osteomyelitis.

We report the case of a 49-year-old man that presented with persistent low back pain after being treated for vertebral osteomyelitis. An abdominopelvic CT scan with intravenous contrast showed a mycotic aneurysm of the abdominal aorta. The patient was taken to the operating room where a bypass reconstruction surgery was successfully performed. The history, pathophysiology, most common organisms, risk factors, and clinical presentation of mycotic aneurysms are discussed. The importance of a high index of suspicion for prompt and proper diagnosis and treatment, is emphasized to create awareness about this dreadful complication of vertebral osteomyelitis.

Cytomegalovirus as nosocomial infection

Nosocomial infections with cytomegalovirus are on area of great concern and controversy within the medical community. With the advent of organ transplantation there rave been an increased number of susceptible individuals. In the past most cases were confined to newborn nurseries and the neonatal intensive care unit. It is of great interested that recent evidence suggests that health care providers are at no greater risk of acquiring CMV infection inside the hospital setting when compared to a representative control group within the same community. This paper will review some of the literature that deals with the nosocomial transmission of CMV. We will try to emphasize transmission, diagnosis, prevention, and treatment of CMV infection

Unusual presentation of pseudomonas aeruginosa infections: a review

Pseudomonas aeruginosa es un bacilo gram negativo, oportunista que causa serias infecciones nosocomiales. Sin embargo, este puede causar infecciones con presentaciones poco usuales adquiridas fuera del ambiente hospitalariao. En este trabajo se discutirá la patogénesis, presentaciones clínicas, y el tratamiento de éstas infecciones poco comunes, como por ejemplo: 1) Foliculitis: infección bacteriana superficial o profunda que se asocia a el uso de saunas y piscinas contaminadas. 2) Otitis externa invasiva: infección que puede progresar hasta la base del cerebro y está asociada mayormente con pacientes diabéticos de avanzada edad. Usualmente esta condición es secundaria a irrigación aural con agua contaminada. 3) Osteomielitis: infección que usualmente se asocia con heridas punzantes con clavos en especial si se tienen puesto zapatos deportivos. 4) Infección entre los dedos de los pies: infección mayormente asociada a individuos utilizando agentes antimicrobianos tópicos. 5) "Green nail syndrome": lesión en la paranoquia no dolorosa que aparece mas comunnente en personas cuyas manos estan en constante exposición al agua, jabones, detergentes o a traumas mecánicos. 6) Keratitis-úlcera en al cornea: mayormente asociada a usuarios de lentes de contacto suave, gotas para los ojos, mascara o piscinas contaminadas. Esta condición podría terminar en una panoftalmitis. 7) Endocarditis: condición mayormente asociada a adictos a drogas intravenosas